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General NPI Number Information
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NPI Number | 1306303573
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Entity Type | Organization
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Legal Business Name | R COLLAZO MEDICAL SERVICES PSC
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Dates
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Enumeration Date | 02/25/2019
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Last Update Date | 02/25/2019
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Provider Practice Location Address
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Address Line | 12 CALLE SOL
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City | SAN GERMAN
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State | PR
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Zip | 00683-3949
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Country | US
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Telephone | 787-892-1333
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 URB NU SIGMA
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City | MAYAGUEZ
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State | PR
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Zip | 00682-7582
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Country | US
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Telephone | 787-464-7271
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. CYNTHIA RAMOS
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Credential |
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Telephone | 787-464-7271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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